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Organization

PROVIDENCE HOSPITAL LLC

Active
Other names
Hospital Professional Services
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY SERAPHINE (PRESIDENT)
(615) 920-7000
Entity
Organization

Contact information

Practice address
2435 FOREST DR, COLUMBIA, SC 29204-2026
(803) 256-5640
(803) 256-5913
Mailing address
2435 FOREST DR, COLUMBIA, SC 29204-2026
(803) 256-5640
(803) 256-5913

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
225100000X
Physical Therapist
225X00000X
Occupational Therapist

Other

Enumeration date
03/04/2016
Last updated
02/22/2017
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